[Skull Only] Folk Figure. He became a legend in medicine for improbably surviving a catastrophic head injury. His is one of the earliest documented cases of severe brain trauma and its effect on personality. Gage was a 25 year-old construction foreman for Vermont's Rutland and Burlington Railroad. One of his main duties was rock-blasting, which involved drilling deep holes into boulders, filling them with gunpowder and sand, then compacting the mixture with a long metal rod called a tamping iron. On September 13, 1848, Gage was working on a length of track near Cavendish, Vermont when a spark accidentally detonated the charge he was preparing. The blast rocketed the tamping iron - which was 3 1/2 feet long and weighed 13 pounds - clear through Gage's head, entering below his left cheekbone and exiting out the top of his skull. It landed some 25 yards away. Most of the front part of the left side of Gage's brain was destroyed. Incredibly, he regained consciousness within minutes, was able to walk unassisted, and remained calm and lucid as he was transported to a local hotel for treatment. He greeted the first physician to arrive with a joke: "Here is enough business for you". The case was turned over to a younger doctor, John Martyn Harlow, who despite his inexperience at what he called "military surgery" did a skillful job of dressing the extensive wounds. Gage nearly died of cerebral infection, but he rebounded and after ten weeks was strong enough to be taken to his parents' home in Lebanon, New Hampshire. By summer 1849 he was deemed physically fit enough to work again, having lost only the vision in his left eye and use of some muscles in that side of his face; his motor and coordinative skills were unimpaired. Dr. Harlow's first written account of the incident, published in the Boston Medical and Surgical Journal (1848), was greeted with wide skepticism until Gage was examined at the Harvard Medical School in November 1849. One eminent professor pronounced his recovery as "unparalleled in the annals of surgery". This brought him brief celebrity, and instead of returning to railroad work he went on a personal appearance tour that was said to have included P. T. Barnum's American Museum in New York and several New England cities. A recently discovered daguerreotype portrait of Gage, showing him well-dressed and proudly holding the tamping iron that nearly killed him, may well have been taken for publicity purposes. Known facts of his subsequent life are scanty. Around 1852 he moved to Chile as an employee of a New England transportation firm and for some years drove a stagecoach along the Valparaiso-Santiago route. He never married. His health apparently remained stable until 1859, when he began to suffer from convulsions and fevers. That year he returned to the US and went to live with his mother near San Francisco, where he died at age 36. Burial was originally at Lone Mountain Cemetery, later renamed Laurel Hill. In 1867 Dr. Harlow had Gage's skull exhumed for further examination; it and the tamping iron are now on permanent display at the Harvard Medical School's Warren Anatomical Museum in Boston. The rest of Gage's remains were transferred to Cypress Lawn in the late 1930s, following the demolition of Laurel Hill Cemetery. The myth of Phineas Gage effectively began in 1868 with Dr. Harlow's second published study. In his previous report Harlow had only hinted at how the accident might have affected the victim's mental state. Two decades later he was much more forthcoming: "Previous to his injury, although untrained in the schools, [Gage] possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was 'no longer Gage'". This account has been disputed because Dr. Harlow treated Gage for less than two years, and there is no conclusive evidence of the long-term effects the injury had on his personality. But it pointed the way to how the subject would be treated by succeeding generations of scientists. (bio by: Bobb Edwards)